[Nutrition therapy for the management of pathological nutritional status in multimorbid elderly patients during...

Population ageing, increasing prevalence of chronic diseases and multimorbidity – and the associated healthcare costs – require a multidisciplinary approach in health care. Major nutrition-related geriatric challenges such as anorexia of ageing and malnutrition, dysphagia, sarcopenia, frailty, sarcopenic obesity, metabolic syndrome, as well as drug–nutrient interactions and iatrogenia form vicious circles that define the main focus areas of nutritional therapy. In 2023, the European Society for Clinical Nutrition and Metabolism provided a new guideline on the nutrition of multimorbid hospitalized patients, followed in 2024 by a concise summary containing practical algorithms. The guideline presents 32 recommendations grouped according to 15 clinically relevant questions on malnutrition screening, personalized nutritional support and its indications, timing, procedure of interventions and monitoring. The nutrition plan is described in detail, covering energy, protein and micronutrient intake and disease-specific considerations. Two-thirds of the recommendations are based on low- to moderate-quality evidence, expert consensus or clinical experience, because the highly heterogeneous population of multimorbid older adults is usually excluded from clinical trials; further research is therefore essential. The international guideline aligns with the Hungarian guidance on the care of multimorbid geriatric patients, with the overarching aim of improving current quality of life and functional capacity through individualized nutritional therapy rather than restrictive diets. All conditions and treatments of multimorbid patients – their present functional performance and activity – must be considered and assessed, while respecting patients’ preferences and the characteristics of the healthcare system. Orv Hetil. 2025; 166(45): 1769–1776.